The aim of this study is to analyze how individuals experience their eating disorder, the focus being if anorexia may be perceived as a secure safe zone in the new modern world. The aim is to examine if individuals affected with anorexia nervosa understand the disorder as a solution to the modern worlds changes and the new individual freedom that it entails. This will be analyzed with the help of terms in Erich Fromms theories about escape mechanisms and Catarina Kinnvalls theories about the modern worlds ontological insecurity. The study is based on data collected from four informants of different ages and gender. The interviews were conducted through email and informants were chosen based on a strategic selection and snowball sampling. For the analysis of the empirical material Fromms escape mechanisms (authoritarianism, destructiveness and automaton conformity) and Kinnvalls theories of identity in the modern world have been used. The results of the analysis show that the eating disorder has a great significance for the individual construction and maintenance of identity and that the eating disorder becomes a safe zone to retreat to in a world of performance anxiety. To escape the anxiety that arises when individuals are faced with unmanageable choices he/she develops anorexia in an attempt to regain a sense of control and security.

O carrapato do boi, Rhipicephalus microplus, é o principal empecilho para o avanço da produção pecuária, causando enormes prejuízos econômicos. Durante a infestação, o carrapato acaba ingerindo uma grande quantidade de imunoglobulinas presentes no soro do hospedeiro. Desse modo, como mecanismo de defesa e com o objetivo de auxiliar o repasto sanguíneo realizado pelas fêmeas, carrapatos machos Ixodidae, secretam proteínas ligantes de IgG (IGBPs) contidas em sua saliva, teoricamente interferindo na ligação específica de anticorpos com antígenos do carrapato, bem como nas funções efetoras da IgG. Raças bovinas taurinas e zebuínas possuem uma peculiar distribuição de alótipos de IgG e, ao mesmo tempo, frente às infestações por carrapatos, tais raças se comportam de maneira distinta, sendo taurinas susceptíveis e zebuínas resistentes a esse ectoparasita. Uma vez que já é relatado na literatura existir diferença na ligação entre as IGBPs de diversos patógenos e os diferentes alótipos de IgG, o presente trabalho teve por objetivo avaliar a natureza das interações entre a IGBP-C de R. microplus e os alótipos de IgG bovina de animais suscetíveis ou resistentes a carrapatos. Para isso, foi feita a genotipagem por sequenciamento da região CH1-CH3 de IgG1 e IgG2, de 40 bovinos da raça taurina Holandesa (Holandês preto e branco - HPB) e 40 bovinos zebuínos da raça Nelore, com posterior purificação do alótipo de IgG1 e IgG2 mais comum em cada raça a partir do soro dos animais homozigotos. Curiosamente, verificou-se que havia uma associação entre os genótipos da região constante da cadeia pesada de IgG1 e IgG2 com os fenótipos de infestação por carrapato observados nos animais estudados. Em seguida, foram realizados ensaios em sistema de Ressonância Plasmônica de Superfície (Biacore T200 - GE Healthcare) para avaliar a afinidade de ligação entre a proteína recombinante IGBP-C e os alótipos de IgG1 e IgG2 bovinas, de uma forma não cognata. Por meio do ensaio em Biacore, observou-se uma maior afinidade de ligação da IGBP-C com alótipos de IgG2 de ambas as raças estudadas em relação aos alótipos de IgG1 e apesar de ligar em mais moléculas do alótipo de IgG2 mais frequente em bovinos Nelore (resistente a carrapato), apresentou uma afinidade maior para o alótipo de IgG2 mais frequente na raça HPB (suscetível a carrapato). Além disso, foi possível confirmar a porção Fc como o sítio de ligação preferencial da IGBP-C na IgG. Por fim, para um maior entendimento da sua função, foi feita a modelagem por homologia da IGBP-C e em ensaios adicionais, visto que essa proteína também interfere no processo de angiogênese, bem como na ativação da via clássica do complemento. Em suma, no presente trabalho foi possível descrever algumas funções promovidas pela IGBP-C, demonstrando assim, a sua importância em compor mecanismos de escape do carrapato R. microplus em relação a resposta imune do hospedeiro / The cattle tick, Rhipicephalus microplus, is the main impediment to the advance of livestock production, causing enormous economic losses. During infestation, the tick ingests a large amount of immunoglobulins present in the host\'s serum. Consequently as a defense mechanism and for assisting the blood meal performed by females, male Ixodidae ticks secrete IgG binding proteins (IGBPs) contained in their saliva, theoretically interfering in the specific binding of antibodies with tick antigens and in the effector functions of IgG. The taurine and zebu bovine breeds have a peculiar distribution of IgG allotypes and also present different phenotypes of tick infestation, being susceptible taurines and zebuines resistant to this ectoparasite. Since it is reported in the literature that there is a difference in the binding between the IGBPs of different pathogens and the different IgG allotypes, the present work aimed to evaluate the nature of the interactions between the IGBP-C of R. microplus and the IgG from susceptible or tick resistant animals. For this, was done genotyping by sequencing of the CH1-CH3 region of IgG1 and IgG2 from forty Holstein taurine and forty Nelore zebu cattle, with subsequent purification of the more common IgG allotypes in each breed, from the serum of homozygous animals. Interestingly, there was an association between IgG1 and IgG2 heavy chain constant region genotypes with tick infestation phenotypes. Subsequently, assays were performed in Surface Plasmon Resonance System (Biacore T200) to evaluate the binding affinity between the recombinant IGBP-C protein and the bovine IgG1 and IgG2 allotypes in a non-cognate manner. Through the Biacore assay, was observed that IGBP-C binding more affinity with IgG2 than IgG1 allotypes of both breeds, and although IGBP-C binds more molecules of the most frequent IgG2 allotype in Nelore tick resistant cattle, showed a higher affinity for the most frequent IgG2 allotype in the HPB, tick susceptible cattle. In addition, it was possible to confirm the Fc portion as the preferred binding site of IGBP-C in IgG. The homology modeling of this protein was done for a better understanding of its function and finally, IGBP-C has also been shown to interfere with the angiogenesis process, as well as in the activation of the classical complement pathway. In short, in the present work it was possible to describe some of the functions promoted by the IGBP-C, thus demonstrating its importance in composing escape mechanisms of the R. microplus tick to the host immune response

O carrapato do boi, Rhipicephalus microplus, é o principal empecilho para o avanço da produção pecuária, causando enormes prejuízos econômicos. Durante a infestação, o carrapato acaba ingerindo uma grande quantidade de imunoglobulinas presentes no soro do hospedeiro. Desse modo, como mecanismo de defesa e com o objetivo de auxiliar o repasto sanguíneo realizado pelas fêmeas, carrapatos machos Ixodidae, secretam proteínas ligantes de IgG (IGBPs) contidas em sua saliva, teoricamente interferindo na ligação específica de anticorpos com antígenos do carrapato, bem como nas funções efetoras da IgG. Raças bovinas taurinas e zebuínas possuem uma peculiar distribuição de alótipos de IgG e, ao mesmo tempo, frente às infestações por carrapatos, tais raças se comportam de maneira distinta, sendo taurinas susceptíveis e zebuínas resistentes a esse ectoparasita. Uma vez que já é relatado na literatura existir diferença na ligação entre as IGBPs de diversos patógenos e os diferentes alótipos de IgG, o presente trabalho teve por objetivo avaliar a natureza das interações entre a IGBP-C de R. microplus e os alótipos de IgG bovina de animais suscetíveis ou resistentes a carrapatos. Para isso, foi feita a genotipagem por sequenciamento da região CH1-CH3 de IgG1 e IgG2, de 40 bovinos da raça taurina Holandesa (Holandês preto e branco - HPB) e 40 bovinos zebuínos da raça Nelore, com posterior purificação do alótipo de IgG1 e IgG2 mais comum em cada raça a partir do soro dos animais homozigotos. Curiosamente, verificou-se que havia uma associação entre os genótipos da região constante da cadeia pesada de IgG1 e IgG2 com os fenótipos de infestação por carrapato observados nos animais estudados. Em seguida, foram realizados ensaios em sistema de Ressonância Plasmônica de Superfície (Biacore T200 - GE Healthcare) para avaliar a afinidade de ligação entre a proteína recombinante IGBP-C e os alótipos de IgG1 e IgG2 bovinas, de uma forma não cognata. Por meio do ensaio em Biacore, observou-se uma maior afinidade de ligação da IGBP-C com alótipos de IgG2 de ambas as raças estudadas em relação aos alótipos de IgG1 e apesar de ligar em mais moléculas do alótipo de IgG2 mais frequente em bovinos Nelore (resistente a carrapato), apresentou uma afinidade maior para o alótipo de IgG2 mais frequente na raça HPB (suscetível a carrapato). Além disso, foi possível confirmar a porção Fc como o sítio de ligação preferencial da IGBP-C na IgG. Por fim, para um maior entendimento da sua função, foi feita a modelagem por homologia da IGBP-C e em ensaios adicionais, visto que essa proteína também interfere no processo de angiogênese, bem como na ativação da via clássica do complemento. Em suma, no presente trabalho foi possível descrever algumas funções promovidas pela IGBP-C, demonstrando assim, a sua importância em compor mecanismos de escape do carrapato R. microplus em relação a resposta imune do hospedeiro / The cattle tick, Rhipicephalus microplus, is the main impediment to the advance of livestock production, causing enormous economic losses. During infestation, the tick ingests a large amount of immunoglobulins present in the host\'s serum. Consequently as a defense mechanism and for assisting the blood meal performed by females, male Ixodidae ticks secrete IgG binding proteins (IGBPs) contained in their saliva, theoretically interfering in the specific binding of antibodies with tick antigens and in the effector functions of IgG. The taurine and zebu bovine breeds have a peculiar distribution of IgG allotypes and also present different phenotypes of tick infestation, being susceptible taurines and zebuines resistant to this ectoparasite. Since it is reported in the literature that there is a difference in the binding between the IGBPs of different pathogens and the different IgG allotypes, the present work aimed to evaluate the nature of the interactions between the IGBP-C of R. microplus and the IgG from susceptible or tick resistant animals. For this, was done genotyping by sequencing of the CH1-CH3 region of IgG1 and IgG2 from forty Holstein taurine and forty Nelore zebu cattle, with subsequent purification of the more common IgG allotypes in each breed, from the serum of homozygous animals. Interestingly, there was an association between IgG1 and IgG2 heavy chain constant region genotypes with tick infestation phenotypes. Subsequently, assays were performed in Surface Plasmon Resonance System (Biacore T200) to evaluate the binding affinity between the recombinant IGBP-C protein and the bovine IgG1 and IgG2 allotypes in a non-cognate manner. Through the Biacore assay, was observed that IGBP-C binding more affinity with IgG2 than IgG1 allotypes of both breeds, and although IGBP-C binds more molecules of the most frequent IgG2 allotype in Nelore tick resistant cattle, showed a higher affinity for the most frequent IgG2 allotype in the HPB, tick susceptible cattle. In addition, it was possible to confirm the Fc portion as the preferred binding site of IGBP-C in IgG. The homology modeling of this protein was done for a better understanding of its function and finally, IGBP-C has also been shown to interfere with the angiogenesis process, as well as in the activation of the classical complement pathway. In short, in the present work it was possible to describe some of the functions promoted by the IGBP-C, thus demonstrating its importance in composing escape mechanisms of the R. microplus tick to the host immune response

Le cancer de la vessie est le 9ème cancer le plus fréquent avec 435 000 nouveaux cas diagnostiqués chaque année et 165 000 décès par an dans le monde. Au diagnostic, 70-80% des cancers de la vessie sont tumeurs superficielles n’infiltrant pas le muscle vésical (TVNIM). Depuis près de 40 ans, les instillations intra-vésicales de bacille de Calmette-Guérin (BCG) sont le traitement de référence des TVNIM ayant un risque élevé de progression (T1, carcinome in situ, Ta haut grade). Malgré un traitement bien conduit, le taux de récidive est d'environ 50%, et la progression vers une tumeur infiltrant le muscle est estimé à 20%-30% dans les 5 ans. Jusqu’à 15% des patients développent des métastases de leur carcinome urothélial. Aujourd’hui, aucun biomarqueur ne permet de prédire la réponse au BCG, ni l’évolution métastatique de la maladie. La cystectomie totale reste le traitement de référence en cas de non-réponse au BCG. Plusieurs essais cliniques évaluent des traitements immuno-modulateurs ciblant les points de contrôle immunitaires PD1, PD-L1 en 2° ligne de traitement après échec du BCG. Les instillations endo-vésicales d’adénovirus recombinant, de virus oncolytique ou d'agoniste de la voie STING sont des stratégies thérapeutiques en cours d'évaluation. L'objectif de ce travail était d'étudier les mécanismes de résistance intrinsèques des cellules tumorales exposées au BCG afin d'identifier de nouvelles cibles thérapeutiques. / Bladder cancer is a heterogeneous disease that displays invasive and non-invasive histological features, and a wide spectrum of molecular alterations and subtypes. Treatment of non-invasive tumors with high-risk features (carcinoma in situ, high-grade Ta, T1) includes trans-urethral resection of the tumor, followed by intravesical instillations of bacillus Calmette-Guérin (BCG). Despite a multitude of evidence for anti-tumor efficacy, 50% of patients with high-risk NMIBC develop tumor recurrence and 20-30% disease progression. Ultimately, 10-15% of patients die of metastatic disease. New therapeutic strategies are currently in clinical development to treat BCG-unresponsive tumors including antagonistic antibodies directed against the T-cell immune checkpoints PD-1, PD-L1 and CTLA-4, but also recombinant adenovirus interferon α (Ad-IFNα/Syn3), oncolytic virus and STING agonists. Although recent studies have identified potential immune parameters that could impact clinical response, mechanisms of tumor resistance to BCG immunotherapy remain poorly understood. Additionally, tumor heterogeneity and plasticity of cancer cells undermine our attempts to precise dynamics of immune escape under selective pressure. How cancer cells evade to the anti-tumor immune response, and whether cancer cells acquire intrinsic undesirable characteristics upon BCG exposure remain unknown. Altogether, this highlights the crucial need to better understand the mechanisms of tumor resistance that occur during BCG immunotherapy in order to identify new targetable pathways and treatment strategies.

Adulte ou pédiatrique, les tumeurs solides ont besoin d’oxygène et de nutriments pour se développer et métastaser. Leur apport est assuré par la néo-vascularisation tumorale issue d’un processus multifactoriel appelé l’angiogénèse. Son équilibre est maintenu par une balance entre facteurs pro- et anti-angiogéniques. Elle fait partie des principales cibles pour traiter les cancers et l’inhibition de la voie VEGF en est un facteur clé. Cependant, la réponse aux agents anti-angiogéniques a montré, malgré des résultats encourageants, un effet transitoire associé à l’apparition d’une résistance adaptative de la tumeur.Nous avons étudié l’inhibition de l’angiogénèse et les mécanismes potentiels d’échappement dans les tumeurs pédiatriques solides, et principalement dans le neuroblastome. Le neuroblastome est une tumeur originaire de la crête neurale et atteint généralement l’enfant jeune. Nous avons exploré l’effet anti-tumoral de l’inhibition sélective des récepteurs 1, 2, 3 du VEGF à l’aide de l’inhibiteur à tyrosine kinase axitinib dans divers modèles précliniques de neuroblastome. L’axitinib a montré une activité anti-tumorale modérée associée à une inhibition de la vascularisation. Néanmoins, après un traitement prolongé in vitro, les cellules tumorales IGR-N91-Luc deviennent résistantes à l’axitinib. Elles prolifèrent normalement mais secrètent de «l’ hepatocyte growth factor» (HGF) et activent la voie MAPK. In vivo, le traitement prolongé par axitinib entraîne le développement d’un phénotype plus agressif de la tumeur avec l’augmentation du nombre d’animaux présentant des métastases, associée à une activation de la voie SRC. Ceci nous a conduit à explorer l’effet d’une inhibition ciblant principalement VEGFR2 et MET (récepteur à l’HGF) avec le cabozantinib. Ainsi nous avons contrôlé le développement tumoral en inhibant la néo-vascularisation et l’activation de SRC, et induit la mort cellulaire dans le modèle orthotopique IGR-N91-Luc et inhibé le développement métastatique dans le modèle systémique IMR-32-Luc. Par ailleurs, nous avons étendu notre exploration à d’autres facteurs jouant un rôle dans l’angiogénèse comme FGFR ou PDGFR car ils représentent, comme MET, de puissants oncogènes. Pour cibler simultanément VEGFR et PDGFR, nous avons utilisé l’inhibiteur multi-kinase regorafenib. In vivo, à des doses bien tolérées qui permettent un traitement prolongé, le regorafenib a montré une activité anti-tumorale significative. Cet effet a été associé principalement à une forte inhibition de la vascularisation mais également à l’induction de la mort cellulaire. En élargissant notre étude à d’autres modèles de tumeurs pédiatriques, nous avons observé que son activité est indépendante du type histologique. Compte tenu du caractère oncogénique de PDGFR, nous avons évalué cet inhibiteur dans des modèles présentant une amplification du gène PDGFRA, qui entraine une surexpression et une activation forte du récepteur. Combiné avec des thérapies standards capables d’induire des dommages à l’ADN telles que l’irradiation ou l’irinotecan, l’effet du regorafenib a été potentialisé, notamment dans les modèles amplifiés pour le gène PDGFRA se traduisant par des régressions tumorales. Ces évaluations précliniques soutiennent le développement d’une nouvelle stratégie thérapeutique pour les enfants atteints de tumeurs solides. / Solid tumors either adult or pediatric need oxygen and nutrients to grow and metastasize. Their input is provided by tumor neovascularization after a multifactorial process called angiogenesis. Balance is maintained by equilibrium between pro and anti-angiogenic factors. It is one of the main targets for treating cancers and the inhibition of the VEGF pathway is a key factor. However, despite encouraging results, the response to anti-angiogenic agents showed a transient effect associated with the development of an adaptive tumor resistance. We studied the inhibition of angiogenesis and potential escape mechanisms in solid pediatric tumors, mainly in neuroblastoma. Neuroblastoma is a solid tumor derived from the neural crest and it usually affects childhood. We investigated the anti-tumor effect of selective inhibition of VEGF receptors 1, 2, 3 using the tyrosine kinase inhibitor axitinib in various preclinical neuroblastoma l models. Axitinib showed a moderate anti-tumor activity associated with the inhibition of vascularization. However, after prolonged treatment in vitro, tumor cells IGR-N91-Luc become resistant to axitinib. They proliferate normally but secrete the "hepatocyte growth factor" (HGF) and activate the MAPK pathway. In vivo, prolonged treatment by axitinib results in the development of a more aggressive tumor phenotype with an increase in the number of animals exhibiting metastases associated with an activation of SRC signaling. This led us to explore the effect of inhibiting concomitant VEGFR2 and MET (HGF receptor), main cabozantinib targets. So we stabilized tumor growth by inhibiting the neovascularization and activation of SRC, induced cell death in the orthotopic model IGR-N91-Luc and inhibited metastatic development in the IMR-32-Luc systemic model. In addition, we extended our exploration of other factors that play a role in angiogenesis like FGFR or PDGFR because they represent, like MET, powerful oncogenes. To simultaneously target VEGFR and PDGFR, we used the multi-kinase inhibitor regorafenib. In vivo, at well-tolerated doses that allow prolonged treatment, regorafenib showed significant anti-tumor activity. This effect was mainly associated with a strong inhibition of vascularization, but also (with) induction of cell death. By expanding our study to other models of pediatric tumors, we observed that its activity was independent of histologic type. Given the oncogenic character of PDGFR, we evaluated the inhibitor in models which present a PDGFRA gene amplification, which results in a strong activation of the receptor. Combined with standard therapies that can induce DNA damages such as irinotecan or radiation, the effect of regorafenib was potentiated, mainly in PDGFRA gene amplified models, where tumor regressions were obtained. These preclinical evaluations support the development of a new therapeutic strategy for children with solid tumors.